Column: Dependable care

Saturday

Jul 25, 2009 at 12:01 AM

This week, a new Harris/Decima poll reported Canadians believe, 82 percent to 8 percent, that their health system is superior to the U.S. system. Here is an explanation from a friend of mine who graduated from Hayden High School, Notre Dame and The University of Kansas Medical School.

"I grew up as a son of an American physician and ultimately became one myself. I watched as my father struggled with five months of cancer, and despite being an advocate of the system and dubious of attempts to change it, he died disillusioned with the insanity of a payment system that jeopardized decades of building security for his family.

"I also recently watched the last years of my sister's life as she battled MS and ultimately cancer, living under financial conditions that we often saw as desperate, but in fact faced by a large segment of the U.S. population on a daily basis.

"Hers was a story of changing insurance plans, pre-existing condition restrictions, dropping off the medical care radar leading to redundant, expensive testing, battling to regain disability status over a period of years during which she lost her job and became wheelchair bound from her disease, still not able to convince the system that she even had the disease.

"Neither my father nor my sister needed Cadillac care. They needed a system that would help them live with diseases for which there is no magic bullet, sadly the case with most diseases and people struggling with them. They needed a system that eased their transition, not one that made their last days a financial nightmare.

"So far I am much more fortunate than either my father, or my sister. But now having lived in Canada for four years, I daresay they would have been better off north of the world's largest national border.

"In Canada, health care is the most important political issue to the voting public, and can make or break a politician's career. The system, pioneered by the agricultural province of Saskatchewan, Kansas' Canadian soul mate, made choices that may limit one's access to the latest and greatest, but true to Canadian egalitarianism, makes sure that all can access the basic medical needs.

"The system is a gatekeeper system, so one must find a primary provider. Waiting is the loudest grumble in Canada, and yes, you may have to wait, especially for some high tech procedures. But interventions that are truly disease and lifespan critical are prioritized.

"Compared to my U.S. experience, I went to my doctor more, because I could, and because he encouraged me to do so. Although he was the gatekeeper, the decisions were his, not those of the insurance company. All the recommended screening procedures at my age I could arrange without worry for the cost to me, or to the system, since prevention is ultimately more economical and is therefore given the priority it should have.

"In my one stay in the hospital after a procedure, I purposely elected the standard arrangement, a four bed ward, rather than paying out of pocket for a semi-private or private room. My three ward mates and I exchanged experiences, encouraged each other and helped each other.

"In four years in Canada, making full use of the system for screening tests, ongoing follow-up, procedures and the occasional urgent need, my out of pocket cost was $0. Well, that is except for drugs, since as an expatriate employee my drug coverage was in the U.S.

''This was a stark contrast from my experience with the U.S. health care system, receiving bills from providers from all directions, pouring over the pile of paperwork for hours trying to figure out what I really owed and to whom (almost always wrong in my conclusion) and fearful that one of the bills may have a fine print threat to send me to collections any day.

"The Canadian Health Care System has its sources of frustration, but compared to my American health care experience I cannot stress too much the psychological advantage of a system that says, 'I can't give you everything, but don't worry, I will cover what you really need.'

"It does, and although Canadians still worry about illness, they do not worry about whether the health care system is truly there for them when their turn comes, and not just for the fortunate few."

Bill Roy is a retired physician and former member of Congress. He has a law degree and lives in Topeka. He may be reached at wirroy@cox.net.

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